Compliance

Compliance with regulatory and policy change is an essential part of any successful claims administration program. Our approach to compliance is twofold. Sedgwick educates colleagues and clients to keep them on top of changes and to ensure consistency with industry best practices. And behind the scenes, our integrated technology solutions incorporate legal and policy requirements into the daily claims and case management workflow, making it easy to support clients’ programs.

Workers’ compensation compliance

Whether for local jurisdictional changes, national legislation or industry trends, Sedgwick helps clients stay on top of workers’ compensation compliance issues and balance them with effective return to work policies. Our team regularly communicates legislative changes and facilitates training to help clients and colleagues understand their impact. Our software platform makes it easy to provide reports in compliance with each state’s individual requirements. We also take on an industry leadership role, partnering with other influencers and exploring new ways to impact future legislation for the benefit of all stakeholders.

Jurisdictional leave compliance

With federal, state and locally mandated leave programs on the rise, Sedgwick is on the forefront of policy trends. We monitor all current and pending legislation and provide timely training for our colleagues and system edits to address changes. Automated system rules help case managers navigate complex requirements and deliver service that is both compliant and supportive. In addition, we communicate any proposed or passed legislation in regular bulletins, keeping our clients and colleagues updated on changes and best practices within the industry.

Client-specific leaves

Sedgwick understands that clients often want to provide their employees with customized, competitive leave programs and we make it easy to incorporate them into overall program management. We work with clients to review guidelines for short- and long-term disability and company-specific leaves, and we provide best practice guidance for shaping procedures and policies. Our software platform incorporates policy rules as part of the integrated workflow, tracking entitlements and time used for both client-specific leaves and claims related to government-mandated programs.

ADA

To maintain compliance under the Americans with Disabilities Act (ADA), there is a need for consistency in an employer’s approach to accommodations and return to work across both occupational and non-occupational injuries and illnesses. The key to reducing risk is to remain informed on current laws and proposed regulations, to have standard procedures in place that will trigger the interactive process, and to implement a system for tracking the accommodation process from start to finish. Sedgwick’s claims and case managers, as well as our job accommodation specialists, support clients as they navigate ADA compliance – and its intersection with FMLA and other regulatory requirements.

Medicare

Assuring proper Medicare compliance has become critical, but navigating the details can be challenging, risky and costly. Sedgwick provides comprehensive Medicare compliance services as an in-house, integrated program option for workers’ compensation and liability claims management. Our team offers a unique approach to Medicare set-asides (MSAs), Medicare lien resolution and medical cost projections. Clients can rely on the efficiencies, quick turnaround time and quality Sedgwick’s experts deliver; the knowledge and confidence that sensitive medical documents and personal information are secure; and the assurance that our overall goal is to drive total claims costs down.

OSHA

Meeting regulatory requirements for OSHA recordkeeping can be a significant challenge for workers’ compensation sponsors. Our approach to OSHA is comprehensive, integrated and built on our years as a national industry leader. We support our clients’ compliance and safety efforts with ongoing education and specialized tools to manage recordkeeping. Our industry-leading viaOne® OSHA technology makes it easy to identify cases that need immediate attention and automate much of the recordkeeping and reporting processes, drastically reducing an employer’s workload and ensuring compliance.

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